Reviews

The Possessed and the Dispossessed: Spirits, Identity and Power in a Madagascar Migrant Town by Lesley A. Sharp.

University of California Press, Berkeley and London. 1993. xx plus 345 pp. including maps, illustrations, tables, notes, bibliography and index.

Marketing Africa's High Value Foods edited by S. Jaffee and J. Morton. World Bank, Kendall/Hunt Publishing Company, Iowa. 1995. 503 pp. including bibliography and index.

Democratisation and Demilitarisation in Lesotho: The General Election of 1993 and its Aftermath edited by Roger Southall and Tsoeu Petlane. Africa Institute of South Africa, Pretoria. 1995. xvii plus 193 pp. R60 ($30).

A Culture of Censorship: Secrecy and Intellectual Repression in South Africa by Christopher Merrett.

David Philip, Cape Town; University of Natal Press, Pietermaritzburg and Mercer University Press, Macon (Georgia). 1994. xv plus 296 pp. including notes and index. Paperback. Price R54,95.

The Eritrean Question: The Conflict Between the Right of Self‐Deter‐mination and the Interests of States by Eyassu Gayim.

Iustus Förlag AB, Uppsala (Sweden). 1993. 716 pp. including figures, tables, notes, maps, annexures bibliography and index. Paperback.

The Rwanda Crisis 1959–1994 — History of a Genocide by G. Prunier. Hurst & Co. London. 1995. xiii plus 389 pp. Paperback. Price £12.50.

Entrance into Reproductive Life: A Demographic Expression of Socio‐Economic Changes in a Senegalese Rural Area by Valérie Delaunay. Centre Français sur la Population et le Développement (CEPED), Paris. 1994. Les Etudes du CEPED No 7. xxii plus 326 pp. including figures, maps, tables, appendices and bibliography. Paperback. Price 90FF.

Verso un Nuovo Sudafrica: Dall'Apartheid allo Stato Multietnico by Chiara Robertazzi.

Milan: Francoangeli. 1995. 130 pp. Paperback.     

Analyzing linked systems of negotiations

This article presents a conceptual framework for analyzing the structure and dynamics of what the authors call linked systems of negotiations. Even such seemingly straightforward transactions as the purchase of a family car tend to involve linked negotiations. The framework highlights the importance of internegotiation processes in shaping Zones of Possible Agreement, and proposes a typology of linkage. By mapping out and reengineering linked systems, negotiators can enhance their ability to shape the structure within which their negotiations take place.     

Setting limits through global budgeting: hospital cost containment in Rhode Island

In 1974, hospitals in Rhode Island have participated in annual negotiations with state officials and representatives from Blue Cross to determine the allowed increase in statewide hospital costs (the "Maxicap") for the next fiscal year, based on projected increases in hospitals' revenues, changes in patient volume and operating expenses. Individual hospital budgets may be above or below the Maxicap as long as the total increase in hospital costs for all hospitals in the state does not exceed the negotiated amount. At a time when regulatory solutions are increasingly under fire, continued support for Rhode Island's approach to hospital cost containment from third party payers, providers and public officials stands in stark contrast to other states where rate setting was either dismantled or discredited as a cost control strategy. A negotiated global cap on hospital expenditures offers an alternative to formula-based state rate-setting methodologies which could be incorporated as part of an all-payer reimbursement methodology or as an incremental step towards more comprehensive reform.     

Pathological myophosphorylase reaction in malignant hyperthermia

In malignant hyperthermia, myophosphorylase reaction shows characteristic changes that take place within minutes: (1) a generally strongly weakened reaction; (2) numerous negatively reacting fibres; (3) frequently, fibre sections that show spotty and/or striatal weak or negative reactions and fibre sections with strong striatal reactions with relatively narrow sarcomere spacings (a "sign of hypercontraction"). Obviously, the morphological findings that show characteristic "striated fibres" are typical of the malignant hyperthermia syndrome! It is important to note that the muscular fibres showing such changes are, as a rule, inconspicuous when using other stains and reactions. These pathological myophosphorylase reactions were observed in five deceased patients (one independently of anaesthesia after an extended walk) and in 19 pigs (18 times after halothane testing and once in an experimental animal with clinical evidence of the presence of malignant hyperthermia). These reactions were not noted in pigs with negative halothane reactivity or prior to halothane testing. They were also not seen in a large number of very different healthy and diseased control and reference cases from our biopsy and autopsy material. Myophosphorylase reaction enables convincing demonstration of malignant hyperthermia, past or present. Hence, it is possible to elucidate puzzling deaths or verify apparently clear death occurring during or subsequent to anaesthesia or simply following stress ("human stress syndrome"). Many of these deaths doubtlessly escape the attention of clinicians using the usual morphological examination methods. However, the reaction cannot be used to identify potential victims.